Proposed here is a multi-faceted approach to the study of patients with the senile maculopathy syndrome, a leading cause of blindness in the United States and other developed countries. The pathogenesis of the lesions leading to visual loss is reasonably well understood in a qualitative way, owing to the pioneer studies of Gass and Sarks. We propose to extend these observations to obtain more quantitative clinical data. A longitudinal study of patients with bilateral macular drusen will be carried out. Efforts will be made to examine and photograph all first degree relatives of patients with drusen to confirm (or refute) the notion that familial drusen and senile drusen are identical nosologic entities. In addition to standard methods of examination, critical flicker fusion frequency curves and other psychophysical tests will be performed in an effort to identify patients at high risk of developing visual loss secondary to progressive retinal pigment epithelial atrophy. Establishing norms for such psychophysical tests (a more sophisticated means of assessing photoreceptor function in the asymptomatic macula) will provide parameters for future investigators to assess the efficacy of various types of medical therapy on the course of dursen in senile macular degeneration. Gass stated that fluorescein angiography was not especially useful in identifying patients destined to develop chorodial neovascular membranes. Therefore, in addition to standard fluorescein fundus photography, indocyanine green angiography will also be performed in an effort to predict which patients with drusen are at a higher than normal risk of developing choroidal neovascularization in the macula. No therapy has been proved effective for any stage of senile maculopathy. Certain eyes with choroidal neovascularization outside the central fovea may be amenable to argon laser photocoagulation treatment. In a clinical trial we will evaluate the role of laser photocoagulation by randomizing eyes judged suitable for photocoagulation into "treatment" and "non-treatment" groups. Two separate groups are proposed based on the position of the choroidal neovascular membrane with respect to the center of the fovea.